Neurological diseases represent a medical, social, and economic problem of paramount importance in developed countries. Although their etiology is generally known, developing therapeutic interventions for the central nervous system is challenging due to the impermeability of the blood-brain barrier. Thus, the fight against neurological diseases usually struggles "at the gates" of the brain. Flooding the bloodstream with drugs, where only a minor fraction reaches its target therapeutic site, is an inefficient, expensive, and dangerous procedure, because of the risk of side effects at nontargeted sites. Currently, advances in the field of nanotechnology have enabled development of a generation of multifunctional molecular platforms that are capable of transporting drugs across the blood-brain barrier, targeting specific cell types or functional states within the brain, releasing drugs in a controlled manner, and enabling visualization of processes in vivo using conventional imaging systems. The marriage between drug delivery and molecular imaging disciplines has resulted in a relatively new discipline, known as theranostics, which represents the basis of the concept of personalized medicine. In this study, we review the concepts of the blood-brain barrier and the strategies used to traverse/bypass it, the role of nanotechnology in theranostics, the wide range of nanoparticles (with emphasis on liposomes) that can be used as stealth drug carriers, imaging probes and targeting devices for the treatment of neurological diseases, and the targets and targeting strategies envisaged in the treatment of different types of brain pathology. Keywords: nanotechnology, theranostics, blood-brain barrier, brain, central nervous systemThe CNS and blood-brain barrier: "the enemy at the gates" Neurological diseases represent a medical, social, and economic problem of paramount importance in developed countries, in particular because their incidence is increasing rapidly with the progressive rise in life expectancy.
1Although the etiology of most neurological diseases is known and experimental studies have continuously provided potential drugs for their treatment, the performance of therapeutic interventions in the central nervous system (CNS) remains a challenge. The CNS is a complex and vulnerable system, and its evolution has provided it with effective mechanisms of defense against foreign elements. Ironically, the strength of these defensive mechanisms usually complicates attempts to perform therapeutic interventions within the CNS.2 Thus, the fight against neurological diseases usually struggles "at the gates" of the brain.There are three main barriers that regulate molecular exchange between the blood and brain parenchyma, including the blood-brain barrier, which is formed by the interaction